ALBERT PROVENCIO

POMONA, CA
NPI1336537554
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101Y00000X Counselor
Enumeration Date2014-12-23
Last Update Date2014-12-23
Business Address
ALBERT PROVENCIO
160 E HOLT AVE B
POMONA, CA 91767-5406
Phone number: 909-620-2521
Mailing Address
ALBERT PROVENCIO
160 E HOLT AVE B
POMONA, CA 91767-5406
Phone number: 909-620-2521
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